Midazolam in gynaecology: the Nigerian experience

In a pilot survey, 11 female patients of ASA grade I, undergoing short elective surgery, received midazolam 0.5 to 0.2 mg/kg for induction of anaesthesia. Indication for surgery was therapeutic or diagnostic evacuations. No narcotic premedication was given, however atropine 0.5 mg i.v. was given at induction just before pre-oxygenation. Anaesthesia was maintained with N20/O2 and halothane 1-3% and ventilation was spontaneous. The study showed that although midazolam did not produce narcosis as rapidly as thiopentone it was devoid of any marked respiratory or cardiovascular depressant effect. Narcosis was however induced within 81 seconds of injection. Midazolam also exhibited an additional anxiolytic effect. No local or system adverse reaction were observed on the day of surgery. There was no incidence of apnoea and no case of post operative vomiting. There was marked anterograde amnesia, only 20% of the patients had some recall of events preceeding induction (just about 30% of events could be remembered). It was therefore concluded that in view of the foregoing, combined with the fact that midazolam injection was painless, recovery rapid and amnesic properties good, midazolam is a drug of choice for day stay surgery.